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Visual assessment of total heart volume and specific chamber size from standard chest radiographs
Insights
Radiologists accurately assessed total heart size visually, but struggled with sub classifying left ventricular enlargement. Experience improved assessment of left ventricular and left atrial sizes.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Accurate assessment of cardiac chamber size is crucial for diagnosing and managing cardiovascular diseases.
- Visual estimation of cardiac dimensions from imaging studies is a common practice among radiologists.
Purpose of the Study:
- To evaluate the accuracy of visual assessment of total heart and individual chamber sizes by radiologists with varying levels of training.
- To determine the impact of radiologist experience and imaging views on the accuracy of cardiac chamber size assessment.
Main Methods:
- Ten radiologists across three training levels visually assessed heart and chamber sizes in 95 adult patients with known cardiac diagnoses.
- Data were analyzed to determine overall accuracy, accuracy for individual chambers, and the influence of enlargement in one chamber on others.
- The ability to subclassify left ventricular enlargement and the utility of oblique views were also investigated.
Main Results:
- Overall accuracy was highest for total heart size (82.2%), followed by left ventricle (79.6%), left atrium (75.0%), and right heart (72.8%).
- Enlargement of the right heart and left atrium negatively impacted the assessment of other chambers.
- Subclassification of left ventricular enlargement into hypertrophy and hypertrophy with dilatation was largely unsuccessful, though detection of abnormality was high.
- Radiologist experience significantly improved the assessment of normal left ventricular and overall left atrial sizes.
Conclusions:
- Visual assessment of total heart size is relatively accurate, but subclassification of left ventricular enlargement presents challenges.
- Radiologist experience is a significant factor in improving the accuracy of assessing left ventricular and left atrial sizes.
- Further research may be needed to refine methods for precise subclassification of cardiac chamber abnormalities.
Abstract:
Ten radiologists at three levels of training visually assessed total heart and individual chamber size in 95 adults of both sexes with well defined cardiac diagnoses. Overall accuracy was highest for total heart size (82.2% correct), followed by left ventricular size, left atrial size and right heart size 79.6%, 75.0%, and 72.8%, respectively. Right heart and left atrial enlargement had a statistically significant negative effect on visual assessment of other chambers (P less than .05). Attempts to subclassify left ventricular enlargement into hypertrophy and hypertrophy and dilatation groups proved unsuccessful. While 63% of the hypertrophy group was detected as abnormal, only 24.3% were correctly subclassified as hypertrophy. For the hypertrophy and dilatation group, the corresponding values were 82% and 70%, respectively. Oblique views were useful in assessing left ventricular size only when inexperienced observers were included in the group of evaluators (P less than .05). A statistically significant improvement in assessment of normal left ventricular size and overall left atrial size was noted with experience (P less than .01 and P less than .05, respectively).